Editorial: Program aims to reduce rate of premature birth

Louisiana may have a lot to brag about these days, but its rating for premature births is not one of them. The state has received an F rating for its 15.3 percent rate of preterm births - a far cry from the goal of 9.6 percent. Louisiana shares this distinction with Mississippi, Alabama and the U.S. territory of Puerto Rico.

What makes Louisiana's ranking even more disgraceful is that many of the preterm births and poor birth outcomes are not beyond the control of the mothers and their doctors.

Many pre-term babies experience short-term or long-term complications, ranging from from respiratory problems at birth to cerebral palsy, according to MayoClinic.com. The severity of the problems is usually related to the degree of prematurity. Most pre-term babies have to spend time in the neonatal intensive care unit and require the care of an average of two specialists.

And since a large portion of premature births occur among the poor, the state and federal government shoulder a good portion of the cost.

The bright spot in all of this is that the Louisiana Department of Health and Hospitals has launched programs aimed at mothers-to-be and their physicians to help ensure more babies are born healthy.

Louisiana DHH Secretary Kathy Kliebert has taken this on as her mission.

The major causes of premature births in Louisiana are maternal hypertension, or high blood pressure, most often because of obesity, maternal substance abuse and smoking through the third trimester, Kliebert told The Daily Advertiser.

The state's score has improved by a little more than a percentage point since last year, Kliebert said, but "we still have a long way to go."

There is also another factor affecting poor birth outcomes, Kliebert said: Elective induction. This is the all-too-common practice in this state of choosing the date when a baby will be born for the sake of convenience, rather than waiting until labor begins spontaneously. In addition to the harming to the baby, who is deprived of the last few critical days or weeks of development, one of the frequent results of elective induction is an increased risk of Caesarean section.

Seventy percent of women who have premature babies are uninsured and are therefore covered by the Bayou Health Plan, which administers Medicaid in Louisiana.

Part of the DHH plan, which will be deployed over the next few years, will be for Bayou Health to identify women who are at high risk of having a premature birth, and shepherd them into programs to help them with their specific problems, be it obesity, substance abuse or smoking - 14 percent of Louisiana mothers smoke through the third trimester, increasing the likelihood of low birth weight babies.

To curtail the practice of elective induction, the March of Dimes has created the "Healthy Babies Can Wait" program to educate mothers-to-be.

Toward the same goal, the U.S. Department of Health and Human Services several years ago launched the 39-Week Initiative, asking doctors and hospitals to avoid inducing labor before a minimum gestation period of 39 weeks. Although a baby is considered premature if it is born at about 36 weeks, 39 weeks or more are needed to ensure a baby is fully developed.

In other states - those that do not have an F rating - it is not uncommon for women to carry their babies past 40 weeks.

Since signing on to the 39-Week Initiative, Lafayette General Medical Center reports fewer babies needing to spend time in their neonatal ICU, according to Darryl Cetnar, a spokesperson for LGMC.

Opelousas General Health System reports only one out of 117 births in the first quarter of the year were elective inductions before 39 weeks.

Kleibert said Bayou Health will soon take the effort to another level. Bayou Health will require that doctors provide evidence of medical necessity for early inductions or face the possibility of not being reimbursed by Medicaid.

It is to be hoped that these efforts will make a positive difference in this distressing situation.

Every effort should be made to ensure that when babies are born in Louisiana, they get to go home with their parents, instead of spending days or weeks alone in the neonatal ICU.

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Email this article

Editorial: Program aims to reduce rate of premature birth

Louisiana may have a lot to brag about these days, but its rating for premature births is not one of them. The state has received an F rating for its 15.3 percent rate of preterm births ? a far cry